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Razavi AC, Jain V, Grandhi GR, Patel P, Karagiannis A, Patel N, Dhindsa DS, Liu C, Desai SR, Almuwaqqat Z, Sun YV, Vaccarino V, Quyyumi AA, Sperling LS, Mehta A. Does Elevated High-Density Lipoprotein Cholesterol Protect Against Cardiovascular Disease? J Clin Endocrinol Metab 2024; 109:321-332. [PMID: 37437107 PMCID: PMC11032254 DOI: 10.1210/clinem/dgad406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/15/2023] [Accepted: 07/07/2023] [Indexed: 07/14/2023]
Abstract
High-density lipoprotein (HDL) contributes to reverse cholesterol transport, which is 1 of the main explanations for the described inverse association between HDL-cholesterol (HDL-C) and atherosclerotic cardiovascular disease (ASCVD) risk. However, efforts to therapeutically raise HDL-C levels with niacin, fibrates, or cholesteryl ester transfer protein inhibitors have not demonstrated a reduction in ASCVD events when compared with placebo among individuals treated with statins. Furthermore, mendelian randomization studies suggest that HDL-C is unlikely to be a direct biologic variable impacting ASCVD risk. More recently, observations from well-conducted epidemiologic studies have indicated a nonlinear U-shaped relationship between HDL-C and subclinical atherosclerosis, and that very high HDL-C (≥80 mg/dL in men, ≥100 mg/dL in women) is paradoxically associated with higher all-cause and ASCVD-related mortality. These observations suggest that HDL-C is not a universal protective factor for atherosclerosis. Thus, there are several opportunities for reframing the contribution of HDL-C to ASCVD risk and related clinical calculators. Here, we examine our growing understanding of HDL-C and its role in ASCVD risk assessment, treatment, and prevention. We discuss the biological functions of HDL-C and its normative values in relation to demographics and lifestyle markers. We then summarize original studies that observed a protective association between HDL-C and ASCVD risk and more recent evidence indicating an elevated ASCVD risk at very high HDL-C levels. Through this process, we advance the discussion regarding the future role of HDL-C in ASCVD risk assessment and identify knowledge gaps pertaining to the precise role of HDL-C in atherosclerosis and clinical ASCVD.
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Affiliation(s)
- Alexander C Razavi
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Vardhmaan Jain
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Gowtham R Grandhi
- Virginia Commonwealth University Health Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA
| | - Parth Patel
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Angelos Karagiannis
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nidhi Patel
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Devinder S Dhindsa
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Chang Liu
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Shivang R Desai
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Zakaria Almuwaqqat
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Yan V Sun
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Viola Vaccarino
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Arshed A Quyyumi
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Laurence S Sperling
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Anurag Mehta
- Virginia Commonwealth University Health Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA
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Razavi AC, Mehta A, Jain V, Patel P, Liu C, Patel N, Eisenberg S, Vaccarino V, Isiadinso I, Sperling LS, Quyyumi AA. High-Density Lipoprotein Cholesterol in Atherosclerotic Cardiovascular Disease Risk Assessment: Exploring and Explaining the "U"-Shaped Curve. Curr Cardiol Rep 2023; 25:1725-1733. [PMID: 37971636 PMCID: PMC10898346 DOI: 10.1007/s11886-023-01987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE OF REVIEW Review updates for the association of HDL-cholesterol with atherosclerotic cardiovascular disease (ASCVD) and discuss the approach to incorporating HDL-cholesterol within risk assessment. RECENT FINDINGS There is a U-shaped relationship between HDL-cholesterol and ASCVD. Both low HDL-cholesterol (< 40 mg/dL in men, < 50 mg/dL in women) and very-high HDL-cholesterol (≥ 80 mg/dL in men) are associated with a higher risk of all-cause and ASCVD mortality, independent from traditional risk factors. There has been inconsistency for the association between very-high HDL-cholesterol and mortality outcomes in women. It is uncertain whether HDL-cholesterol is a causal ASCVD risk factor, especially due to mixed results from Mendelian randomization studies and the collinearity of HDL-cholesterol with established risk factors, lifestyle behaviors, and socioeconomic status. HDL-cholesterol is a risk factor or risk enhancer in primary prevention and high-risk condition in secondary prevention when either low (men and women) or very-high (men). The contribution of HDL-cholesterol to ASCVD risk calculators should reflect its observed U-shaped association with all-cause and ASCVD mortality.
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Affiliation(s)
- Alexander C Razavi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Anurag Mehta
- Virginia Commonwealth University Health Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Vardhmaan Jain
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Parth Patel
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Chang Liu
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Nidhi Patel
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Scott Eisenberg
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Ijeoma Isiadinso
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Laurence S Sperling
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA.
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Rhee TM, Bae JW, Park KW, Rha SW, Kang J, Lee H, Yang HM, Kwak SH, Chae IH, Shin WY, Kim DK, Oh JH, Jeong MH, Kim YH, Lee NH, Hur SH, Yoon J, Han JK, Shin ES, Koo BK, Kim HS. Aspirin vs Clopidogrel for Long-term Maintenance After Coronary Stenting in Patients With Diabetes: A Post Hoc Analysis of the HOST-EXAM Trial. JAMA Cardiol 2023; 8:535-544. [PMID: 37043192 PMCID: PMC10099092 DOI: 10.1001/jamacardio.2023.0592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 02/20/2023] [Indexed: 04/13/2023]
Abstract
Importance Selecting the optimal antiplatelet agent in patients who have received percutaneous coronary intervention is especially important in those with diabetes due to the heightened risk of ischemic events in this population. Studies on the efficacy and safety of clopidogrel vs aspirin for long-term maintenance after percutaneous coronary intervention in patients with diabetes are lacking. Objective To investigate cardiovascular outcomes with clopidogrel vs aspirin in patients with and without diabetes. Design, Setting, and Participants This was a post hoc analysis of the HOST-EXAM randomized clinical trial, an investigator-initiated, prospective, randomized, open-label, multicenter trial performed at 37 centers in Korea. Patients who received dual antiplatelet therapy without clinical events for 6 to 18 months after percutaneous coronary intervention with drug-eluting stents were enrolled from March 2014 to May 2018 with follow-up at 6, 12, 18, and 24 months. All 5438 patients in the original trial were included in this analysis, which was conducted from June to October 2021. Interventions and Exposures Enrolled patients were randomized 1:1 to clopidogrel or aspirin monotherapy. Subgroup analyses were performed by the presence of diabetes. Main Outcomes and Measures The main outcome was primary composite end point of all-cause death, nonfatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and major bleeding (Bleeding Academic Research Consortium type 3 or 5) at 24-month follow-up. Results Of 5438 patients (mean [SD] age, 63.5 [10.7] years; 1384 [25.5%] female), 1860 (34.2%) had diabetes (925 in the clopidogrel arm and 935 in the aspirin arm), and 5338 (98.2%) completed follow-up. The rate of the primary composite end point was significantly lower in the clopidogrel group compared to the aspirin group in patients with diabetes (6.3% vs 9.2%; hazard ratio [HR], 0.69; 95% CI, 0.49-0.96; P = .03; absolute risk difference [ARD], 2.7%; number needed to treat [NNT], 37) and without diabetes (5.3% vs 7.0%; HR, 0.76; 95% CI, 0.58-1.00; P = .046; ARD, 1.6%, NNT, 63; P for interaction = .65). The presence of diabetes was not associated with a difference in benefit observed with clopidogrel monotherapy over aspirin for the thrombotic composite end point (HR, 0.68; 95% CI, 0.45-1.04 for patients with diabetes vs HR, 0.68; 95% CI, 0.49-0.93 for those without; P for interaction = .99) and any bleeding with Bleeding Academic Research Consortium 2, 3, or 5 (HR, 0.65; 95% CI, 0.39-1.09 for patients with diabetes vs HR, 0.74; 95% CI, 0.48-1.13 for those without; P for interaction = .71). Conclusion and Relevance In this study, clopidogrel monotherapy was associated with a lower rate of the primary composite end point compared to aspirin monotherapy as long-term maintenance therapy after dual antiplatelet therapy for coronary stenting in both patients with and without diabetes. Clopidogrel might thus be considered rather than aspirin in patients who have undergone coronary stenting and successfully completed dual antiplatelet therapy, regardless of diabetes status. Trial Registration ClinicalTrials.gov Identifier: NCT02044250.
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Affiliation(s)
- Tae-Min Rhee
- Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Jang-Whan Bae
- Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kyung Woo Park
- Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | | | - Jeehoon Kang
- Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Heesun Lee
- Seoul National University Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Mo Yang
- Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Soo-Heon Kwak
- Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - In-Ho Chae
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - Won-Yong Shin
- Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | | | - Ju Hyeon Oh
- Samsung Changwon Hospital, Sungkyunkwan University, Changwon, Korea
| | | | - Yong Hoon Kim
- Kangwon National University, School of Medicine, Chuncheon, Korea
| | - Nam Ho Lee
- Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - Seung-Ho Hur
- Keimyung University Dongsan Hospital, Daegu, Korea
| | - Junghan Yoon
- Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Jung-Kyu Han
- Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | | | - Bon-Kwon Koo
- Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
| | - Hyo-Soo Kim
- Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
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Maes M, Brinholi FF, Michelin AP, Matsumoto AK, de Oliveira Semeão L, Almulla AF, Supasitthumrong T, Tunvirachaisakul C, Barbosa DS. In Mild and Moderate Acute Ischemic Stroke, Increased Lipid Peroxidation and Lowered Antioxidant Defenses Are Strongly Associated with Disabilities and Final Stroke Core Volume. Antioxidants (Basel) 2023; 12:antiox12010188. [PMID: 36671047 PMCID: PMC9854933 DOI: 10.3390/antiox12010188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
In acute ischemic stroke (AIS), there are no data on whether oxidative stress biomarkers have effects above and beyond known risk factors and measurements of stroke volume. This study was conducted in 122 mild-moderate AIS patients and 40 controls and assessed the modified ranking scale (mRS) at baseline, and 3 and 6 months later. We measured lipid hydroperoxides (LOOH), malondialdehyde (MDA), advanced oxidation protein products, paraoxonase 1 (PON1) activities and PON1 Q192R genotypes, high density lipoprotein cholesterol (HDL), sulfhydryl (-SH) groups), and diffusion-weighted imaging (DWI) stroke volume and fluid-attenuated inversion recovery (FLAIR) signal intensity. We found that (a) AIS is characterized by lower chloromethyl acetate CMPAase PON1 activity, HDL and -SH groups and increased LOOH and neurotoxicity (a composite of LOOH, inflammatory markers and glycated hemoglobin); (b) oxidative and antioxidant biomarkers strongly and independently predict mRS scores 3 and 6 months later, DWI stroke volume and FLAIR signal intensity; and (c) the PON1 Q192R variant has multiple effects on stroke outcomes that are mediated by its effects on antioxidant defenses and lipid peroxidation. Lipid peroxidation and lowered -SH and PON1-HDL activity are drug targets to prevent AIS and consequent neurodegenerative processes and increased oxidative reperfusion mediators due to ischemia-reperfusion injury.
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Affiliation(s)
- Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Rd., Phayathai Road, Pathumwan, Bangkok 10330, Thailand
- Cognitive Fitness and Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Department of Psychiatry, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
- Research Institute, Medical University Plovdiv, 4000 Plovdiv, Bulgaria
- Deakin University, IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, VIC 3220, Australia
- Correspondence:
| | - Francis F. Brinholi
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Ana Paula Michelin
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Andressa K. Matsumoto
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Laura de Oliveira Semeão
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Abbas F. Almulla
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf 54001, Iraq
| | - Thitiporn Supasitthumrong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Rd., Phayathai Road, Pathumwan, Bangkok 10330, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Rd., Phayathai Road, Pathumwan, Bangkok 10330, Thailand
| | - Decio S. Barbosa
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
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Wang X, Li B, Hu Y, Xiao S, Guo M, Xu T, Wu H, Huan C, Yin J, Zhu H, Pan D. Novel grading system for ischemia‒reperfusion injury manifestations in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention. Sci Rep 2022; 12:19349. [PMID: 36369283 PMCID: PMC9652336 DOI: 10.1038/s41598-022-24019-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
To establish a simple myocardial ischemia‒reperfusion injury (MIRI) manifestation grading system based on clinical manifestations and coronary angiography during primary percutaneous coronary intervention (PPCI). All STEMI patients treated with PPCI from June 2018 to November 2019 were included. According to the MIRI manifestation grade, patients were divided into four grades (I-IV). Laboratory and clinical indicators of the patients and the occurrence of major adverse cardiac events (MACEs) within one year of follow-up were analyzed. A total of 300 patients were included. The higher the MIRI manifestation grade, the lower was the high-density lipoprotein cholesterol (HDL-C); the higher were the C-reactive protein (CRP), lipoprotein(a) [LP(a)], and peak levels of high-sensitivity troponin T (hs-cTnT), creatine kinase (CK-MB), and N-terminal pro-B-type natriuretic peptide (NT-proBNP); and the higher were the proportions of right coronary artery (RCA) and multivessel lesions (P < 0.05). The left ventricular end-diastolic dimension (LVEDD) and E/e' values of patients with higher grades were significantly increased, while the LVEF, left ventricular short-axis functional shortening (LVFS) and E/A values were significantly decreased (P < 0.05). The one-year cumulative incidence of major adverse cardiac events (MACEs) in patients with grade I-IV disease was 7.7% vs. 26.9% vs. 48.4% vs. 93.3%, respectively, P < 0.05. The higher the MIRI manifestation grade, the more obvious is the impact on diastolic and systolic function and the higher is the cumulative incidence of MACEs within one year, especially in patients with multivessel disease, low HDL-C, high CRP, high LP(a) levels, and the RCA as the infarction-related artery.
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Affiliation(s)
- Xiaotong Wang
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Binbin Li
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006 Jiangsu China
| | - Yue Hu
- grid.413389.40000 0004 1758 1622Department of General Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004 Jiangsu China
| | - Shengjue Xiao
- grid.263826.b0000 0004 1761 0489Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009 Jiangsu China
| | - Minjia Guo
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Tao Xu
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Huimin Wu
- grid.413389.40000 0004 1758 1622Department of General Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004 Jiangsu China
| | - Chunyan Huan
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Jie Yin
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Hong Zhu
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
| | - Defeng Pan
- grid.413389.40000 0004 1758 1622Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
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Karabacak M, Uysal BA, Turkdogan AK. Alteration in serum oxidative stress balance in patients with different circulating high-density lipoprotein cholesterol levels. Rev Port Cardiol 2022; 41:833-839. [DOI: 10.1016/j.repc.2021.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022] Open
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Sorokin AV, Patel N, Abdelrahman KM, Ling C, Reimund M, Graziano G, Sampson M, Playford M, Dey AK, Reddy A, Teague HL, Stagliano M, Amar M, Chen MY, Mehta N, Remaley AT. Complex association of apolipoprotein E-containing HDL with coronary artery disease burden in cardiovascular disease. JCI Insight 2022; 7:159577. [PMID: 35389891 PMCID: PMC9220837 DOI: 10.1172/jci.insight.159577] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background Although traditional lipid parameters and coronary imaging techniques are valuable for cardiovascular disease (CVD) risk prediction, better diagnostic tests are still needed. Methods In a prospective, observational study, 795 individuals had extensive cardiometabolic profiling, including emerging biomarkers, such as apolipoprotein E–containing HDL-cholesterol (ApoE-HDL-C). Coronary artery calcium (CAC) score was assessed in the entire cohort, and quantitative coronary computed tomography angiography (CCTA) characterization of total burden, noncalcified burden (NCB), and fibrous plaque burden (FB) was performed in a subcohort (n = 300) of patients stratified by concentration of ApoE-HDL-C. Total and HDL-containing apolipoprotein C-III (ApoC-III) were also measured. Results Most patients had a clinical diagnosis of coronary artery disease (CAD) (n = 80.4% of 795), with mean age of 59 years, a majority being male (57%), and about half on statin treatment. The low ApoE-HDL-C group had more severe stenosis (11% vs. 2%, overall P < 0.001), with higher CAC as compared with high ApoE-HDL-C. On quantitative CCTA, the high ApoE-HDL-C group had lower NCB (β = –0.24, P = 0.0001), which tended to be significant in a fully adjusted model (β = –0.32, P = 0.001) and altered by ApoC-III in HDL levels. Low ApoE-HDL-C was significantly associated with LDL particle number (β = 0.31; P = 0.0001). Finally, when stratified by FB, ApoC-III in HDL showed a more robust predictive value of CAD over ApoE-HDL-C (AUC: 0.705, P = 0.0001) in a fully adjusted model. Conclusion ApoE-containing HDL-C showed a significant association with early coronary plaque characteristics and is affected by the presence of ApoC-III, indicating that low ApoE-HDL-C and high ApoC-III may be important markers of CVD severity. Trial Registration ClinicalTrials.gov: NCT01621594. Funding This work was supported by the NHLBI at the NIH Intramural Research Program.
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Affiliation(s)
- Alexander V Sorokin
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Nidhi Patel
- Section of Inflammation and Cardiometabolic Diseases, NIH, NHLBI, Bethesda, United States of America
| | - Khaled M Abdelrahman
- Section of Inflammation and Cardiometabolic Diseases, NIH, NHLBI, Bethesda, United States of America
| | - Clarence Ling
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Mart Reimund
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Giorgio Graziano
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Maureen Sampson
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Martin Playford
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, NIH, NHLBI, Bethesda, United States of America
| | - Aarthi Reddy
- Section of Inflammation and Cardiometabolic Diseases, NIH, NHLBI, Bethesda, United States of America
| | - Heather L Teague
- Section of Inflammation and Cardiometabolic Diseases, NIH, NHLBI, Bethesda, United States of America
| | - Michael Stagliano
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Marcelo Amar
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Marcus Y Chen
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
| | - Nehal Mehta
- Section of Inflammation and Cardiometabolic Diseases, NIH, NHLBI, Bethesda, United States of America
| | - Alan T Remaley
- Section of Lipoprotein Metabolism, Translational Vascular Medicine Branch, NIH, NHLBI, Bethesda, United States of America
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Kopčeková J, Kolesárová A, Schwarzová M, Kováčik A, Mrázová J, Gažarová M, Lenártová P, Chlebo P, Kolesárová A. Phytonutrients of Bitter Apricot Seeds Modulate Human Lipid Profile and LDL Subfractions in Adults with Elevated Cholesterol Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020857. [PMID: 35055679 PMCID: PMC8775948 DOI: 10.3390/ijerph19020857] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 12/10/2022]
Abstract
The objective of the present study was to evaluate the effect of short-term consumption of bitter apricot seeds phytonutrients on cardiovascular risk factors with a special focus on LDL cholesterol subfractions using the Lipoprint system. A group of 34 adult volunteers (21 female/13 male) consumed 60 mg kg−1 of body weight of bitter apricot seeds daily for 42 days. Subjects were divided into two groups: one with normal cholesterol levels (NTC) and one with elevated total cholesterol levels (ETC). Blood serum levels of total cholesterol (T-C), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C), and triglycerides (TG) did not change significantly (p > 0.05) in NTC group. However, there were significant decreasing of T-C (p ˂ 0.05) and LDL-C (p < 0.01) in ETC group. The LDL1, LDL2, and atherogenic LDL3−7 subfractions progressively decreased after 42 days of apricot seeds consumption in ETC group (p < 0.05). Apricot seeds consumption was associated with a significant increase in the mean LDL particle size especially in ETC group (p ˂ 0.01). The results of the present study support the hypothesis that daily consumption of bitter apricot seeds for 42 days positively modified the lipoprotein profile in the group with elevated total cholesterol.
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Affiliation(s)
- Jana Kopčeková
- Institute of Nutrition and Genomics, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia; (M.S.); (J.M.); (M.G.); (P.L.); (P.C.)
- Correspondence: ; Tel.: +421-37-641-4225
| | - Anna Kolesárová
- Institute of Food Sciences, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia;
| | - Marianna Schwarzová
- Institute of Nutrition and Genomics, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia; (M.S.); (J.M.); (M.G.); (P.L.); (P.C.)
| | - Anton Kováčik
- Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia; (A.K.); (A.K.)
| | - Jana Mrázová
- Institute of Nutrition and Genomics, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia; (M.S.); (J.M.); (M.G.); (P.L.); (P.C.)
| | - Martina Gažarová
- Institute of Nutrition and Genomics, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia; (M.S.); (J.M.); (M.G.); (P.L.); (P.C.)
| | - Petra Lenártová
- Institute of Nutrition and Genomics, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia; (M.S.); (J.M.); (M.G.); (P.L.); (P.C.)
| | - Peter Chlebo
- Institute of Nutrition and Genomics, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia; (M.S.); (J.M.); (M.G.); (P.L.); (P.C.)
| | - Adriana Kolesárová
- Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, 949 76 Nitra, Slovakia; (A.K.); (A.K.)
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9
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Coban N, Ozuynuk AS, Erkan AF, Guclu-Geyik F, Ekici B. Levels of miR-130b-5p in peripheral blood are associated with severity of coronary artery disease. Mol Biol Rep 2021; 48:7719-7732. [PMID: 34689283 DOI: 10.1007/s11033-021-06780-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/20/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although patients with coronary artery disease (CAD) have a high mortality rate, the pathogenesis of CAD is still poorly understood. During the past decade, microRNAs (miRNAs) have emerged as new, potential diagnostic biomarkers in several diseases, including CAD. This study aimed to investigate the expression profiles of miRNAs in individuals with CAD and non-CAD. METHODS AND RESULTS The Agilent's microarray analyses were performed to compare the whole blood miRNA profile of selected individuals with severe CAD (n = 12, ≥ 90% stenosis) and non-CAD (n = 12, ≤ 20 stenosis). Expressions of selected differentially expressed miRNAs (DEMs) were analyzed for validation in individuals with critical CAD (n = 50) and non-CAD (n = 43) using real-time PCR. Target prediction tools were utilized to identify miRNA target genes. We identified 6 DEMs that were downregulated in CAD patients, which included hsa-miR-18a-3p and hsa-miR-130b-5p, that were analyzed for further testing. Expression levels of hsa-miR-130b-5p were found negatively correlated with SYNTAX score and stenosis in female CAD patients (p < 0.05). In addition, both miRNAs were found positively correlated with plasma HDL and inversely correlated with fasting triglyceride levels (p < 0.05). In linear regression analysis adjusted for several confounders, the correlations have remained statistically significant. Computational prediction of target genes indicated a relevant role of hsa-miR-130b-5p and hsa-miR-18a-3p in modulating the expression of genes associated with cardiovascular diseases. CONCLUSION Our findings highlight a significantly different pattern of miRNA expression in CAD patients in microarray results. Hsa-miR-18a-3p and hsa-miR-130b-5p might serve as biomarkers of CAD development and progression and warrant further attention.
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Affiliation(s)
- Neslihan Coban
- Department of Genetics, Aziz Sancar Institute for Experimental Medicine, Istanbul University, Istanbul, Turkey.
| | - Aybike Sena Ozuynuk
- Department of Genetics, Aziz Sancar Institute for Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Aycan Fahri Erkan
- Department of Cardiology, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Filiz Guclu-Geyik
- Department of Genetics, Aziz Sancar Institute for Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Berkay Ekici
- Department of Cardiology, Faculty of Medicine, Ufuk University, Ankara, Turkey
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10
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Xue Y, Shen J, Hong W, Zhou W, Xiang Z, Zhu Y, Huang C, Luo S. Risk stratification of ST-segment elevation myocardial infarction (STEMI) patients using machine learning based on lipid profiles. Lipids Health Dis 2021; 20:48. [PMID: 33957898 PMCID: PMC8101132 DOI: 10.1186/s12944-021-01475-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/21/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Numerous studies have revealed the relationship between lipid expression and increased cardiovascular risk in ST-segment elevation myocardial infarction (STEMI) patients. Nevertheless, few investigations have focused on the risk stratification of STEMI patients using machine learning algorithms. METHODS A total of 1355 STEMI patients who underwent percutaneous coronary intervention were enrolled in this study during 2015-2018. Unsupervised machine learning (consensus clustering) was applied to the present cohort to classify patients into different lipid expression phenogroups, without the guidance of clinical outcomes. Kaplan-Meier curves were implemented to show prognosis during a 904-day median follow-up (interquartile range: 587-1316). In the adjusted Cox model, the association of cluster membership with all adverse events including all-cause mortality, all-cause rehospitalization, and cardiac rehospitalization was evaluated. RESULTS All patients were classified into three phenogroups, 1, 2, and 3. Patients in phenogroup 1 with the highest Lp(a) and the lowest HDL-C and apoA1 were recognized as the statin-modified cardiovascular risk group. Patients in phenogroup 2 had the highest HDL-C and apoA1 and the lowest TG, TC, LDL-C and apoB. Conversely, patients in phenogroup 3 had the highest TG, TC, LDL-C and apoB and the lowest Lp(a). Additionally, phenogroup 1 had the worst prognosis. Furthermore, a multivariate Cox analysis revealed that patients in phenogroup 1 were at significantly higher risk for all adverse outcomes. CONCLUSION Machine learning-based cluster analysis indicated that STEMI patients with increased concentrations of Lp(a) and decreased concentrations of HDL-C and apoA1 are likely to have adverse clinical outcomes due to statin-modified cardiovascular risks. TRIAL REGISTRATION ChiCTR1900028516 ( http://www.chictr.org.cn/index.aspx ).
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Affiliation(s)
- Yuzhou Xue
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Jian Shen
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Weifeng Hong
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Wei Zhou
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Zhenxian Xiang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Yuansong Zhu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Chuiguo Huang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Suxin Luo
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
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11
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La-Up A, Saengow U, Aramrattana A. High serum high-density lipoprotein and low serum triglycerides in Kratom users: A study of Kratom users in Thailand. Heliyon 2021; 7:e06931. [PMID: 33997428 PMCID: PMC8102425 DOI: 10.1016/j.heliyon.2021.e06931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/22/2021] [Accepted: 04/22/2021] [Indexed: 12/14/2022] Open
Abstract
Objective The present study aims to examine the association between Kratom use and serum lipid level. Method This study compared the serum lipid profile of Kratom users and non-users living in Nam Phu Subdistrict, a special area that allows the traditional use of Kratom. The study subjects consisted of 581 individuals aged 18 and above. Binary logistic regression was used to determine an association between Kratom use and serum lipid level. Results The findings revealed an association between Kratom use and an elevated HDL level (≥60 mg/dL) with an adjusted OR of 1.82 (95% CI, 1.17-2.8), and an association between Kratom use and a triglyceride level <90 mg/dL with an adjusted OR of 1.75 (95% CI; 1.17-2.63). There were no associations between Kratom use and LDL as well as total cholesterol level. Discussion and conclusions This study provided additional evidence of Kratom use and a favorable lipid profile. Prevention of coronary heart disease or cerebrovascular disease via an improvement in the lipid profile may be a future pharmaceutical application of Kratom.
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Affiliation(s)
- Aroon La-Up
- School of Public Health, Walailak University, 222 Thai Buri, Tha Sala, Nakhon Si Thammarat 80160, Thailand
| | - Udomsak Saengow
- School of Medicine, Walailak University, 222 Thai Buri, Tha Sala, Nakhon Si Thammarat 80160, Thailand.,Center of Excellence in Data Science for Health Study, 222 Thai Buri, Tha Sala, Nakhon Si Thammarat 80160, Thailand.,Research Institute for Health Sciences, 222 Thai Buri, Tha Sala, Nakhon Si Thammarat 80160, Thailand
| | - Apinun Aramrattana
- Faculty of Medicine, Department of Family Medicine, Chiang Mai University, Chiang Mai, Thailand.,Northern Substance Abuse Center, Department of Family Medicine, Chiang Mai University, Chiang Mai, Thailand
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12
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Yu Y, Hu L, Huang X, Zhou W, Bao H, Cheng X. BMI modifies the association between serum HDL cholesterol and stroke in a hypertensive population without atrial fibrillation. J Endocrinol Invest 2021; 44:173-181. [PMID: 32406023 DOI: 10.1007/s40618-020-01288-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Both high-density lipoprotein cholesterol (HDL-C) and body mass index (BMI) have an impact on the prevalence of stroke. However, it is unclear whether BMI can modify the relationship between HDL-C and stroke. Therefore, we aimed to assess the effect of the BMI on the association between HDL-C and stroke in a hypertensive population without atrial fibrillation (AF). METHODS We analyzed data of 10,925 hypertensive patients without AF from the Chinese Hypertension Registry Study. BMI was categorized as < 24 and ≥ 24 kg/m2. Multivariate logistic regression and smooth curve fitting (penalized spline method) were used to analyze the association between HDL-C and stroke in different BMI groups. Subgroup analysis and interaction tests were used to explore the effect of other variables on this relationship. RESULTS The results showed a negative association between HDL-C and stroke in the BMI < 24 kg/m2 group, but HDL-C was not associated with stroke in the BMI ≥ 24 kg/m2 group. In the BMI < 24 kg/m2 group, each 1 mmol/L increase in HDL-C was associated with a 50% decreased risk of stroke [odds ratio (OR) 0.50, 95% confidence interval (CI) 0.38-0.66]. No significant relationship between HDL-C and stroke was observed in the BMI ≥ 24 kg/m2 group (OR 0.73, 95% CI 0.49-1.10). There was a significant interaction between BMI and HDL-C in regard to the prevalence of stroke in the hypertensive population without AF (PInteraction = 0.027). CONCLUSIONS We found an inverse association between HDL-C and stroke only in the BMI < 24 kg/m2 group. The finding suggested that BMI could modify the association between HDL-C and stroke in hypertensive populations without AF.
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Affiliation(s)
- Y Yu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China
| | - L Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China
| | - X Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China
| | - W Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - H Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China.
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - X Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China.
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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13
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Impact of High-Density Lipoprotein Levels on Cardiovascular Outcomes of Patients Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents. Am J Cardiol 2020; 137:1-6. [PMID: 33002465 DOI: 10.1016/j.amjcard.2020.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 11/24/2022]
Abstract
Low levels of high-density lipoprotein (HDL) have been associated with adverse cardiovascular events in epidemiologic studies. Evidence regarding its role in patients who underwent percutaneous coronary intervention (PCI) is scarce. We evaluated consecutive patients who underwent PCI with drug-eluting stents from 2012 to 2017, excluding those with unavailable baseline HDL, age <18 years, presentation with ST-segment elevation myocardial infarction (MI) or shock, and coexisting neoplastic disease. The final population was stratified according to baseline HDL levels into reduced and nonreduced HDL cohorts, with cut-off value 40 mg/dl in males and 50 mg/dl in females. The primary end point was 1-year major adverse cardiovascular events (MACE), defined as the composite of death, MI, or target vessel revascularization (TVR). Among 10,843 patients included, 6,511 (60%) had reduced HDL, and 4,332 (40%) nonreduced HDL. The rate of 1-year MACE was similar between the 2 groups (7.5% vs 6.6%; p = 0.14). Although mortality and MI rates were comparable, reduced HDL was associated with significantly higher TVR 5.2% vs 4.0%; p = 0.02, a finding that attenuated after multivariable adjustment (adjusted hazard ratio 1.18, p = 0.14). Sex subgroup analysis included 7,718 (71.2%) males and 3,125 (28.8%) females. Among men, there was a trend toward higher MACE in those with reduced HDL (7.4% vs 6.0%; p = 0.08) mostly driven by TVR (5.4% vs 3.7%; p = 0.005). No association between HDL and 1-year outcomes was evident in females. Assessment for interaction between sex and reduced HDL did not reach statistical significance. In conclusion, reduced baseline HDL was not associated with increased risk of MACE in a contemporary PCI population.
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14
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Sorokin AV, Karathanasis SK, Yang ZH, Freeman L, Kotani K, Remaley AT. COVID-19-Associated dyslipidemia: Implications for mechanism of impaired resolution and novel therapeutic approaches. FASEB J 2020; 34:9843-9853. [PMID: 32588493 PMCID: PMC7361619 DOI: 10.1096/fj.202001451] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/12/2022]
Abstract
The current coronavirus disease 2019 (COVID‐19) pandemic presents a global challenge for managing acutely ill patients and complications from viral infection. Systemic inflammation accompanied by a “cytokine storm,” hemostasis alterations and severe vasculitis have all been reported to occur with COVID‐19, and emerging evidence suggests that dysregulation of lipid transport may contribute to some of these complications. Here, we aim to summarize the current understanding of the potential mechanisms related to COVID‐19 dyslipidemia and propose possible adjunctive type therapeutic approaches that modulate lipids and lipoproteins. Specifically, we hypothesize that changes in the quantity and composition of high‐density lipoprotein (HDL) that occurs with COVID‐19 can significantly decrease the anti‐inflammatory and anti‐oxidative functions of HDL and could contribute to pulmonary inflammation. Furthermore, we propose that lipoproteins with oxidized phospholipids and fatty acids could lead to virus‐associated organ damage via overactivation of innate immune scavenger receptors. Restoring lipoprotein function with ApoA‐I raising agents or blocking relevant scavenger receptors with neutralizing antibodies could, therefore, be of value in the treatment of COVID‐19. Finally, we discuss the role of omega‐3 fatty acids transported by lipoproteins in generating specialized proresolving mediators and how together with anti‐inflammatory drugs, they could decrease inflammation and thrombotic complications associated with COVID‐19.
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Affiliation(s)
- Alexander V Sorokin
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sotirios K Karathanasis
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,NeoProgen, Baltimore, MD, USA
| | - Zhi-Hong Yang
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lita Freeman
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Department of Clinical Laboratory Medicine, Jichi Medical University, Shimotsuke-City, Japan
| | - Alan T Remaley
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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15
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Castaño D, Rattanasopa C, Monteiro-Cardoso VF, Corlianò M, Liu Y, Zhong S, Rusu M, Liehn EA, Singaraja RR. Lipid efflux mechanisms, relation to disease and potential therapeutic aspects. Adv Drug Deliv Rev 2020; 159:54-93. [PMID: 32423566 DOI: 10.1016/j.addr.2020.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 02/06/2023]
Abstract
Lipids are hydrophobic and amphiphilic molecules involved in diverse functions such as membrane structure, energy metabolism, immunity, and signaling. However, altered intra-cellular lipid levels or composition can lead to metabolic and inflammatory dysfunction, as well as lipotoxicity. Thus, intra-cellular lipid homeostasis is tightly regulated by multiple mechanisms. Since most peripheral cells do not catabolize cholesterol, efflux (extra-cellular transport) of cholesterol is vital for lipid homeostasis. Defective efflux contributes to atherosclerotic plaque development, impaired β-cell insulin secretion, and neuropathology. Of these, defective lipid efflux in macrophages in the arterial walls leading to foam cell and atherosclerotic plaque formation has been the most well studied, likely because a leading global cause of death is cardiovascular disease. Circulating high density lipoprotein particles play critical roles as acceptors of effluxed cellular lipids, suggesting their importance in disease etiology. We review here mechanisms and pathways that modulate lipid efflux, the role of lipid efflux in disease etiology, and therapeutic options aimed at modulating this critical process.
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16
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Lechner K, McKenzie AL, Kränkel N, Von Schacky C, Worm N, Nixdorff U, Lechner B, Scherr J, Weingärtner O, Krauss RM. High-Risk Atherosclerosis and Metabolic Phenotype: The Roles of Ectopic Adiposity, Atherogenic Dyslipidemia, and Inflammation. Metab Syndr Relat Disord 2020; 18:176-185. [PMID: 32119801 PMCID: PMC7196362 DOI: 10.1089/met.2019.0115] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Current algorithms for assessing risk of atherosclerotic cardiovascular disease (ASCVD) and, in particular, the reliance on low-density lipoprotein (LDL) cholesterol in conditions where this measurement is discordant with apoB and LDL-particle concentrations fail to identify a sizeable part of the population at high risk for adverse cardiovascular events. This results in missed opportunities for ASCVD prevention, most notably in those with metabolic syndrome, prediabetes, and diabetes. There is substantial evidence that accumulation of ectopic fat and associated metabolic traits are markers for and pathogenic components of high-risk atherosclerosis. Conceptually, the subset of advanced lesions in high-risk atherosclerosis that triggers vascular complications is closely related to a set of coordinated high-risk traits clustering around a distinct metabolic phenotype. A key feature of this phenotype is accumulation of ectopic fat, which, coupled with age-related muscle loss, creates a milieu conducive for the development of ASCVD: atherogenic dyslipidemia, nonresolving inflammation, endothelial dysfunction, hyperinsulinemia, and impaired fibrinolysis. Sustained vascular inflammation, a hallmark of high-risk atherosclerosis, impairs plaque stabilization in this phenotype. This review describes how metabolic and inflammatory processes that are promoted in large measure by ectopic adiposity, as opposed to subcutaneous adipose tissue, relate to the pathogenesis of high-risk atherosclerosis. Clinical biomarkers indicative of these processes provide incremental information to standard risk factor algorithms and advanced lipid testing identifies atherogenic lipoprotein patterns that are below the discrimination level of standard lipid testing. This has the potential to enable improved identification of high-risk patients who are candidates for therapeutic interventions aimed at prevention of ASCVD.
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Affiliation(s)
- Katharina Lechner
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | | | - Nicolle Kränkel
- Klinik Für Kardiologie, Campus Benjamin Steglitz, Charité—Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Clemens Von Schacky
- Preventive Cardiology, Ludwig-Maximilians University, Munich, Germany
- Omegametrix, Martinsried, Germany
| | - Nicolai Worm
- German University for Prevention and Health Care Management, Saarbrücken, Germany
| | | | - Benjamin Lechner
- Department of Internal Medicine IV, Ludwig-Maximilians University, Munich, Germany
| | - Johannes Scherr
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Ronald M. Krauss
- University of California, San Francisco, San Francisco, California, USA
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17
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Zhou Y, Yang HY, Zhang HL, Zhu XJ. High-density lipoprotein cholesterol concentration and acute kidney injury after noncardiac surgery. BMC Nephrol 2020; 21:149. [PMID: 32334566 PMCID: PMC7183648 DOI: 10.1186/s12882-020-01808-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 04/15/2020] [Indexed: 02/02/2023] Open
Abstract
Background Abnormal High-density Lipoprotein Cholesterol Concentration is closely related to postoperative acute kidney injury (AKI) after cardiac surgeries. The purpose of this study was to analyze the relationship between High-density Lipoprotein Cholesterol Concentration and acute kidney injury after non-cardiac surgeries. Method This was a single-center cohort study for elective non-cardiac non-kidney surgery from January 1, 2012, to December 31, 2017. The endpoint was the occurrence of acute kidney injury (AKI) 7 days postoperatively in the hospital. Preoperative serum High-density Lipoprotein Cholesterol Concentration was examined by multivariate logistic regression models before and after propensity score weighting analysis. Results Of the 74,284 surgeries, 4.4% (3159 cases) suffered acute kidney injury. The odds ratio for HDL (0.96–1.14 as reference, < 0.96, 1.14–1.35, > 1.35) was 1.28 (1.14–1.41), P < 0.001; 0.91 (0.80–1.03), P = 0.150; 0.75 (0.64–0.85), P < 0.001, respectively. Using a dichotomized cutoff point for propensity analysis, Preoperative serum HDL < 1.03 mmol/L (> 1.03 as reference) was associated with increased risk of postoperative AKI, with odds ratio 1.40 (1.27 ~ 1.52), P < 0.001 before propensity score weighting, and 1.32 (1.21–1.46), P < 0.001 after propensity score weighting. Sensitivity analysis with other cut values of HDL showed similar results. Conclusions Using multivariate regression analyses before and after propensity score weighting, in addition to multiple sensitivity analysis methods, this study found that following non-cardiac surgery, low HDL cholesterol levels were independent risk factors for AKI.
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Affiliation(s)
- Yan Zhou
- Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, 100034, China.
| | - Hong-Yun Yang
- Department of Laboratory, Peking University First Hospital, Beijing, 100034, China
| | - Hui-Li Zhang
- Department of information center, Peking University First Hospital, Beijing, 100034, China
| | - Xiao-Jin Zhu
- Department of information center, Peking University First Hospital, Beijing, 100034, China
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18
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Barbosa CJDG, Maranhão RC, Barreiros RS, Freitas FR, Franci A, Strunz CMC, Arantes FBB, Tavoni TM, Ramires JAF, Kalil Filho R, Nicolau JC. Lipid transfer to high-density lipoproteins in coronary artery disease patients with and without previous cerebrovascular ischemic events. Clin Cardiol 2019; 42:1100-1105. [PMID: 31489679 PMCID: PMC6837020 DOI: 10.1002/clc.23259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/27/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Patients with coronary artery disease (CAD) and previous ischemic cerebrovascular events (ICVE, ischemic stroke, or transitory ischemic attack) constitute a high-risk subgroup for cardiovascular outcomes. High-density lipoprotein cholesterol (HDL-C) levels are correlated with cardiovascular events. Lipid transfer to HDL affects structure size and HDL subclass profile. Impairment of this transfer could influence ischemic risk seen in patients with CAD + ICVE. The objective was to evaluate the HDL ability to receive the lipids in patients with CAD with or without ICVE. METHODS Patients with CAD + ICVE (n = 60) and patients with CAD only (n = 60) were matched by age, sex, acute coronary syndromes (ACS) event type, and time elapsed between the ACS event and inclusion in the study. Lipid transfer to HDL was evaluated by incubating donor lipid nanoparticles labeled with radioactive unesterified cholesterol (UC) and esterified cholesterol (EC), phospholipid (PL), and triglyceride (TG) with whole plasma. After the chemical precipitation of non-HDL fractions and nanoparticles, the supernatant was counted for HDL radioactivity. RESULTS CAD + ICVE group presented with impaired lipid transfer to HDL for PL (CAD + ICVE: 21.14 ± 2.7% vs CAD: 21.67 ± 3.1%, P = .03), TG (CAD + ICVE: 4.88 ± 0.97% vs CAD: 5.63 ± 0.92%, P = .002), and UC (CAD + ICVE: 5.55 ± 1.19% vs CAD: 6.16 ± 1.14%, P = .009). Lipid transfer to HDL was similar in both groups for EC. Adjusted models showed similar results. CONCLUSION Patients with CAD and ICVE have reduced lipid transfer to HDL compared to those with CAD only. Dysfunctional HDL may account for the higher incidence of ischemic outcomes observed in this population.
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Affiliation(s)
- Carlos J D G Barbosa
- Hospital do Coracao do Brasil, Brasília, Brazil.,Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Raul C Maranhão
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Faculdade de Ciencias Farmaceuticas, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Renata S Barreiros
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Fatima R Freitas
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - André Franci
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Célia M C Strunz
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Thauany M Tavoni
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José A F Ramires
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Roberto Kalil Filho
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José C Nicolau
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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19
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Pan M, Deng Y, Zheng C, Nie H, Tang K, Zhang Y, Yang Q. The effects of Qigong exercises on blood lipid profiles of middle-aged and elderly individuals: A systematic review and network meta-analysis. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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20
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Baum SJ, Scholz KP. Rounding the corner on residual risk: Implications of REDUCE-IT for omega-3 polyunsaturated fatty acids treatment in secondary prevention of atherosclerotic cardiovascular disease. Clin Cardiol 2019; 42:829-838. [PMID: 31254481 PMCID: PMC6727875 DOI: 10.1002/clc.23220] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/06/2019] [Accepted: 06/12/2019] [Indexed: 01/24/2023] Open
Abstract
Patients with established atherosclerotic cardiovascular (CV) disease remain at increased risk of major adverse cardiovascular events even during optimal lipid-lowering therapy. Recent studies using the methods of Mendelian randomization, as well as analyses of data from large statin trials, have concluded that elevated triglyceride (TG) levels contribute to that increased risk. Omega-3 polyunsaturated fatty acids (omega-3 PUFAs) from fish and shellfish (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) reduce TG levels when added to the diet in sufficient amounts, and they have favorable effects on several other markers of CV risk. However, trials of omega-3 PUFAs have had inconsistent findings regarding CV risk reduction. Recently, the REDUCE-IT (Reduction of Cardiovascular Events with EPA-Intervention Trial) trial reported that treatment of such high-risk patients with icosapent ethyl, a purified and stabilized ethyl ester of EPA, reduced the risk of the trial's primary CV endpoint by 25% (95% confidence intervals [CI], 32%-17%; P < .001). To appreciate the clinical implications of this result, it is important to understand how the REDUCE-IT trial differed from previous trials, especially with regard to patient enrollment criteria and treatment dosing. We discuss these design features relative to other trials. TG lowering can account for only part of the risk reduction seen with icosapent ethyl; we also consider other potential contributory mechanisms.
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Affiliation(s)
- Seth J. Baum
- Excel Medical Clinical TrialsBoca RatonFlorida,Department of Integrated Medical Science, Florida Atlantic UniversityCharles E. Schmidt College of MedicineBoca RatonFlorida
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21
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Reiche EMV, Gelinksi JR, Alfieri DF, Flauzino T, Lehmann MF, de Araújo MCM, Lozovoy MAB, Simão ANC, de Almeida ERD, Maes M. Immune-inflammatory, oxidative stress and biochemical biomarkers predict short-term acute ischemic stroke death. Metab Brain Dis 2019; 34:789-804. [PMID: 30875023 DOI: 10.1007/s11011-019-00403-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/25/2019] [Indexed: 12/19/2022]
Abstract
The aim of the study was to define new immune-inflammatory, oxidative stress and biochemical biomarkers, which predict mortality within a period of 3 months after acute ischemic stroke (AIS). We recruited 176 healthy volunteers and 145 AIS patients, categorized as AIS survivors and non-survivors, and measured interleukin (IL)-6, high sensitivity C-reactive protein (hsCRP), ferritin, iron, total serum protein (TSP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), 25 hydroxyvitamin D [25(OH)D], lipid hydroperoxides (CL-LOOH), insulin, glucose and high-density lipoprotein (HDL)-cholesterol. In patients, these biomarkers were measured within 24 h after AIS onset. We also computed two composite scores reflecting inflammatory indices, namely INFLAM index1 (sum of z scores of hsCRP+IL-6 + ferritin+ESR + WBC) and INFLAM index2 (z INFLAM index1 - z 25(OH)D - z iron + z TSP). Three months after AIS, non-survivors (n = 54) showed higher baseline levels of IL-6, hsCRP, ferritin and glucose and lower levels of HDL-cholesterol and 25(OH)D than survivors (n = 91). Non-survivors showed higher baseline ESR and lowered TSP than controls, while survivors occupied an intermediate position. Death after AIS was best predicted by increased IL-6, glucose, ferritin and CL-LOOH and lowered 25(OH)D levels. The area under the receiver operating curves computed on the INFLAM index1 and 2 scores were 0.851 and 0.870, respectively. In conclusion, activation of peripheral immune-inflammatory, oxidative and biochemical pathways is critically associated with mortality after AIS. Our results may contribute to identify new biomarker sets, which may predict post-stroke death, as well as suggest that IL-6 trans-signaling coupled with redox imbalances may be possible new targets in the prevention of short-term outcome AIS death.
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Affiliation(s)
- Edna Maria Vissoci Reiche
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, Londrina State University, Av. Robert Koch, 60, CEP 86.038-440, Londrina, Paraná, Brazil.
| | - Jair Roberto Gelinksi
- Clinical and Laboratory Pathophysiology Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Daniela Frizon Alfieri
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Tamires Flauzino
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Marcio Francisco Lehmann
- Department of Clinical Surgery, Health Sciences Center, and Neurosurgery Service of the University Hospital, State University of Londrina, Londrina, Paraná, Brazil
| | | | - Marcell Alysson Batisti Lozovoy
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, Londrina State University, Av. Robert Koch, 60, CEP 86.038-440, Londrina, Paraná, Brazil
| | - Andrea Name Colado Simão
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, Londrina State University, Av. Robert Koch, 60, CEP 86.038-440, Londrina, Paraná, Brazil
| | - Elaine Regina Delicato de Almeida
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, Londrina State University, Av. Robert Koch, 60, CEP 86.038-440, Londrina, Paraná, Brazil
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Psychiatry, Medical University Plovdiv, Plovdiv, Bulgaria
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Allard-Ratick MP, Kindya BR, Khambhati J, Engels MC, Sandesara PB, Rosenson RS, Sperling LS. HDL: Fact, fiction, or function? HDL cholesterol and cardiovascular risk. Eur J Prev Cardiol 2019; 28:166–173. [PMID: 33838035 DOI: 10.1177/2047487319848214] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 04/14/2019] [Indexed: 11/17/2022]
Abstract
The measurement of high-density lipoprotein cholesterol is highly utilized by clinicians to help predict cardiovascular risk, but this measure is not causally associated with atherosclerotic cardiovascular disease events. The use of Mendelian randomization studies has led to a change in investigative attention from the high-density lipoprotein cholesterol concentration to its physiological functions. High-density lipoprotein plays key roles in important pathways related to the development of atherosclerotic disease including reverse cholesterol transport, oxidation and inflammation, and endothelial function as well as in other physiological systems including immune system modulation, cellular apoptosis, and endothelial progenitor cell homeostasis. The identification of dysfunctional high-density lipoprotein may better predict future cardiovascular events compared to numerical high-density lipoprotein cholesterol and aid in enhanced clinical risk stratification. The emergence of discrete physiological measurements of high-density lipoprotein, such as cholesterol efflux capacity and the high-density lipoprotein inflammatory index, may provide an opportunity for clinical application in the future. However, the validity of these measurements and their commercial availability remain barriers to a realistic transition to clinical medicine.
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Affiliation(s)
| | - Bryan R Kindya
- Department of Internal Medicine, Emory University School of Medicine, USA
| | - Jay Khambhati
- Department of Internal Medicine, Emory University School of Medicine, USA
| | - Marc C Engels
- Department of Internal Medicine, Emory University School of Medicine, USA
| | | | - Robert S Rosenson
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, USA
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Arikan GD, Isbir S, Yilmaz SG, Isbir T. Characteristics of Coronary Artery Disease Patients Who Have a Polymorphism in the Cholesterol Ester Transfer Protein ( CETP) Gene. In Vivo 2019; 33:787-792. [PMID: 31028198 PMCID: PMC6559892 DOI: 10.21873/invivo.11540] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/16/2019] [Accepted: 02/25/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Cholesterol ester transfer protein (CETP) is responsible for the transformation of high density lipoprotein (HDL) to low density lipoprotein (LDL) and is a risk factor for atherosclerosis. Our study investigated the association of the rs5883 CETP gene polymorphism with HDL and LDL levels, in 45 coronary artery disease patients and 45 control patients. MATERIALS AND METHODS CETP gene polymorphism was detected using Real Time-Polymerase Chain Reaction (RT-PCR). Lipoprotein levels were measured using Quantimetrix system. RESULTS There were lack of associaition regarding CETP polymorphism in atherosclerosis and HDL and LDL levels (p>0.05) BMI was higher among coronary artery disease patients (CADP) compared to the control group (28.97±6.38, 26.52±4.39 respectively, p<0.03). Frequency of CADP (82.6 %, n=19) who were taking treatment was higher (17.4 %, n=4) (p<0.00). The frequencies of hypertension and type-2 diabetes were higher among CADP (p<0.00). Families of CADP have more CADP (p<0.02). Small HDL particle levels were higher in the control group (p<0.00). CONCLUSION In Turkey, BMI, and frequencies of hypertension and type-2 diabetes were higher among CADP than among healthy controls. Furthermore, the genotypes of the rs5883 CETP gene polymorphism did not differ between CADP and healthy controls.
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Affiliation(s)
- Güliz Dirimen Arikan
- Nursing Department, Faculty of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Selim Isbir
- Department of Cardiovascular Surgery, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
| | - Seda Güleç Yilmaz
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Turgay Isbir
- Department of Medical Biology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
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Wang X, Liu X, Xie Z, Tian J, Huang X, Zhang R, Chen S, Hou J, Yu B. Small HDL subclass is associated with coronary plaque stability: An optical coherence tomography study in patients with coronary artery disease. J Clin Lipidol 2018; 13:326-334.e2. [PMID: 30665770 DOI: 10.1016/j.jacl.2018.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND The role of high-density lipoprotein (HDL) subclasses in atherosclerotic diseases remains an open question. Previous clinical trials have attempted to explore the predictive effect of HDL subspecies on cardiovascular risk. However, no studies have assessed the connections between these subclasses and characteristics of plaque microstructure. OBJECTIVE To investigate the relationship of HDL subclasses and coronary plaque stability assessed by optical coherence tomography (OCT). METHODS Morphological characteristics of 160 nontarget lesions from 85 patients with coronary artery disease were assessed by OCT. HDL subclass profiles were analyzed using nondenaturing polyacrylamide gel electrophoresis. RESULTS The plasma levels of small HDL subclass (percentage or concentration) were found to be positively associated with fibrous cap thickness (r = 0.232, P = .007; r = 0.243, P = .005) and negatively with maximum lipid arc (r = -0.240, P = .005; r = -0.252, P = .003) and lipid core length (r = -0.350, P < .001; r = -0.367, P < .001). Multivariate logistic regression analysis showed the small HDL subclass (percentage or concentration) (odds ratio [OR]: 0.457, 95% confidence interval [CI]: 0.214-0.974, P = .043; OR: 0.438, 95% CI: 0.204-0.938, P = .034) to be an independent factor in predicting OCT-detected thin-cap fibroatheroma of nontarget lesions. CONCLUSION High levels of small HDL are associated with coronary nontarget plaque stability. Our findings suggest that the small HDL subtype might represent the atheroprotective activity of HDL.
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Affiliation(s)
- Xuedong Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Xinxin Liu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Zulong Xie
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinwei Tian
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Xingtao Huang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Ruoxi Zhang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Shuyuan Chen
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Jingbo Hou
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
| | - Bo Yu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
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25
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Jan CF, Chang HC, Tantoh DM, Chen PH, Liu WH, Huang JY, Wu MC, Liaw YP. Duration-response association between exercise and HDL in both male and female Taiwanese adults aged 40 years and above. Oncotarget 2018; 9:2120-2127. [PMID: 29416758 PMCID: PMC5788626 DOI: 10.18632/oncotarget.23251] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 12/01/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Exercise is an important cardiovascular risk reducing therapy. OBJECTIVE The aim of this study was to assess the relationship between weekly exercise duration and high-density lipoprotein cholesterol (HDL-c) in Taiwanese men and women. METHODS Data were retrieved from the dataset of the national adult preventive medical services which is recorded under the Health Promotion Administration (HPA). The lipid profiles of 194528 eligible participants aged 40 years and above who completed a questionnaire on recent health behavior including smoking, drinking, exercise and other factors in 2014 were determined. Weekly exercise durations of 0.0, <2.5 and ≥2.5 hours were classified as no, below recommended and recommended, respectively. The relationship between exercise and HDL-c was determined using linear regression. RESULTS After multivariate adjustments, a duration-response association existed between exercise and HDL-c (P-trend <0.0001) in both sexes. Weekly exercise durations of <2.5 and ≥2.5 hours were both positively associated with HDL-c (P <0.0001) in both sexes. However, the associations were stronger in males than females in both exercise groups. Smoking (P <0.05) and BMI (P <0.0001) were negatively associated while drinking was positively associated with HDL-c in both sexes. CONCLUSION This study demonstrated a duration-response association between exercise and HDL-c. Exercise at durations below the minimum weekly recommendation of 2.5 hours was positively associated with HDL-c.
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Affiliation(s)
- Cheng-Feng Jan
- Office of Physical Education, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Hui-Chin Chang
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
- Library, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Disline Manli Tantoh
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
| | - Pei-Hsin Chen
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
| | - Wen- Hsiu Liu
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
| | - Jing-Yang Huang
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
| | - Min-Chen Wu
- Office of Physical Education, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Yung-Po Liaw
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan
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26
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Xu RX, Zhang Y, Guo YL, Ma CY, Yao YH, Li S, Li XL, Qing P, Gao Y, Wu NQ, Zhu CG, Liu G, Dong Q, Sun J, Li JJ. Novel findings in relation to multiple anti-atherosclerotic effects of XueZhiKang in humans. Chronic Dis Transl Med 2017; 4:117-126. [PMID: 29988855 PMCID: PMC6033954 DOI: 10.1016/j.cdtm.2017.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Indexed: 01/07/2023] Open
Abstract
Background Previous studies have clearly demonstrated that XueZhiKang (XZK), an extract of cholestin, can decrease low-density lipoprotein cholesterol (LDL-C) and cardiovascular events. However, the mechanism of the effects of XZK on atherosclerosis (AS) in humans has been reported less frequently. In the present study, we investigated the impact of XZK on lipoprotein subfractions, oxidized LDL (oxLDL), and interleukin-6 (IL-6). Methods From October 2015 to July 2016, 40 subjects were enrolled in this study. Of them, 20 subjects with dyslipidemia received XZK 1200 mg/day for 8 weeks (XZK group); 20 additional healthy subjects who did not receive therapy acted as controls. The plasma lipoprotein subfractions, oxLDL, and IL-6 were examined at baseline and again at 8 weeks. Results Data showed that XZK could significantly decrease not only plasma LDL-C levels (87.26 ± 24.45 vs. 123.34 ± 23.99, P < 0.001), total cholesterol (4.14 ± 0.87 vs. 5.08 ± 1.03, P < 0.001), triglycerides (0.95 ± 0.38 vs. 1.55 ± 0.61, P < 0.05), and apolipoprotein B (1.70 ± 0.35 vs. 1.81 ± 0.72, P < 0.05), but also oxLDL (36.36 ± 5.31 vs. 49.20 ± 15.01, P < 0.05) and IL-6 (8.50 ± 7.40 vs. 10.40 ± 9.49, P < 0.05). At the same time, XZK reduced the concentration of small LDL-C (1.78 ± 2.17 vs. 6.33 ± 7.78, P < 0.05) and the percentage of the small LDL subfraction (1.09 ± 1.12 vs. 3.07 ± 3.09, P < 0.05). Conclusions Treatment with 1200 mg/day XZK for 8 weeks significantly decreased the atherogenic small LDL subfraction and reduced oxidative stress and inflammatory markers, in addition to affecting the lipid profile, suggesting multiple beneficial effects in coronary artery disease.
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Affiliation(s)
- Rui-Xia Xu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yan Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chun-Yan Ma
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yu-Hong Yao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Sha Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiao-Lin Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ping Qing
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ying Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Na-Qiong Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Geng Liu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jing Sun
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Alenazi AM, Alshehri MM, Hoover JC, Yabroudi MA, Kachanathu SJ, Liu W. The Effect of T'ai Chi Exercise on Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Altern Complement Med 2017; 24:220-230. [PMID: 28934556 DOI: 10.1089/acm.2017.0104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Cardiovascular disease is a common health problem resulting from many factors, including dyslipidemia. T'ai chi is one of the interventions assigned to improve lipid profiles and other physical outcomes. However, conflicting results might be attributed to different study designs and interventional approaches. A systematic review and meta-analysis are needed to evaluate existing evidence. OBJECTIVE The aim of this systematic review and meta-analysis is to evaluate existing randomized clinical trials (RCTs) regarding the overall effect of t'ai chi exercise on lipid profiles. METHODS Electronic databases (MEDLINE and Cumulative Index to Nursing and Allied Health Literature) were searched. The authors included only English peer reviewed published RCTs that used a t'ai chi intervention and high-density lipoprotein cholesterol (HDL-C) as the primary outcome along with low-density lipoprotein cholesterol (LDL-C) and/or total cholesterol (TC) as secondary outcomes. RESULTS The authors identified 37 potentially eligible studies. Only eight RCTs were eligible for their qualitative review, and seven studies were eligible for meta-analysis. The included studies were rated as having a low risk of bias. Despite the overall low risk of bias, all studies failed to blind participants to group assignment and were generally unclear about whether they were selectively reporting data. A fixed effect model (I2 = 38.16%) demonstrated a small positive effect of t'ai chi on HDL-C (Cohen d = 0.12; standard error [SE] = 0.067; p = 0.037). A random effect model demonstrated a medium effect and small effect for LDL-C (Cohen d = 0.47; SE = 0.347; p = 0.089) and TC (Cohen d = 0.34; SE = 0.225; p = 0.066), respectively. CONCLUSION T'ai chi may potentially be beneficial on lipid profiles across different age groups and populations. Although there were conflicting results regarding the effect of t'ai chi on lipid profiles, the majority of studies had at least a small positive effect indicating a potential positive effect of t'ai chi on HDL-C, LDL-C, and/or TC. Therefore, further research is needed to confirm the small positive effect of t'ai chi on lipid profiles found in this review.
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Affiliation(s)
- Aqeel M Alenazi
- 1 Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center , Kansas City, KS
- 2 Department of Rehabilitation Health Sciences and Physical Therapy, Prince Sattam Bin Abdulaziz University , Alkharj, Kingdom of Saudi Arabia
| | - Mohammed M Alshehri
- 1 Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center , Kansas City, KS
- 3 Department of Physical Therapy, Jazan University , Jazan, Kingdom of Saudi Arabia
| | - Jeffrey C Hoover
- 1 Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center , Kansas City, KS
| | - Mohammad A Yabroudi
- 4 Department of Rehabilitation Sciences, Jordan University for Science and Technology , Irbid, Jordan
| | - Shaji John Kachanathu
- 5 College of Applied Medical Sciences, King Saud University , Riyadh, Kingdom of Saudi Arabia
| | - Wen Liu
- 1 Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center , Kansas City, KS
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Li KC, Yu SH, Zhuge BZ. PIK3CG single nucleotide polymorphisms are associated with poor responsiveness to clopidogrel and increased risk of ischemia in patients with coronary heart disease. Medicine (Baltimore) 2017; 96:e7566. [PMID: 28885323 PMCID: PMC6392743 DOI: 10.1097/md.0000000000007566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study explores the associations between PIK3CG single nucleotide polymorphisms (SNPs, rs1129293 and rs17398575) and patient responsiveness to clopidogrel to evaluate the risks of ischemia in patients with coronary heart disease (CHD). METHODS The study consisted of 513 CHD patients who received clopidogrel as part of antiplatelet therapy, after percutaneous coronary intervention. According to the patient responsiveness to clopidogrel, the subjects were assigned to either clopidogrel-resistant (CR) or clopidogrel-sensitive (CS) groups. CR group was determined by patients' platelet aggregation rate of ≥70% and poor responsiveness to clopidogrel, and CS group by patients' platelet aggregation rates of <70% and good responsiveness to clopidogrel. Polymerase chain reaction using TaqMan probe was employed to detect PIK3CG polymorphism. Haplotype and linkage disequilibrium analyses were performed. Prognosis analysis was performed using the Kaplan-Meier curve. RESULTS Significant difference was found in genotype and rs1129293 and rs17398575 allele frequency between the CR and CS groups. Haplotype analysis indicated that the frequency of TG allele was higher in the CR group compared with the CS group, and the frequency of CA allele was lower in the CR group compared with the CS group. Patients with rs1129293 CT + TT genotype and T allele, rs1129293 AG + GG genotype and G allele exhibited an increased CR risk. Logistic regression analysis determined hypertension history as an independent risk factor for CR. The Kaplan-Meier curve suggests that distribution curve of cumulative probability nonischemic events was different between patients with rs1129293 and rs17398575 alleles. Stable CHD patients with TT genotype of rs1129293 allele and GG genotype of rs17398575 allele showed poorer prognosis compared to those with other genotypes and patients with acute coronary syndromes. CONCLUSION A positive correlation may exist between PIK3CG SNPs (rs1129293 and rs17398575) and patients with poor responsiveness to clopidogrel. These findings show that this factor may contribute to an increased risk of ischemia in patients suffering from CHD.
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Affiliation(s)
- Ke-Cheng Li
- Department of Clinical Laboratory, People's Hospital of Rongcheng, Rongcheng
| | - Shu-Hong Yu
- Department of Blood Transfusion, Yantai Yuhuangding Hospital, Yantai
| | - Bao-Zhong Zhuge
- Department of Clinical Laboratory, Linyi People's Hospital, Linyi, P.R. China
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Liu HH, Guo YL, Wu NQ, Zhu CG, Gao Y, Qing P, Li S, Zhao X, Zhang Y, Sun D, Liu G, Dong Q, Li JJ. High-density lipoprotein cholesterol levels are associated with coronary severity but not with outcomes in new-onset patients with stable coronary artery disease. Atherosclerosis 2017. [PMID: 28623739 DOI: 10.1016/j.atherosclerosis.2017.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS The atheroprotective role of high-density lipoprotein cholesterol (HDL-C) levels in coronary artery disease (CAD) remains controversial. This study sought to reappraise the value of HDL-C in predicting the severity and outcomes of new-onset patients with stable CAD in Chinese populations. METHODS A total of 4205 new-onset patients with stable CAD who received coronary angiography were enrolled to analyze the relation of HDL-C to coronary severity and major adverse cardiovascular events (MACEs). Coronary severity was evaluated by Gensini scoring system. The MACEs included all-cause death, non-fatal myocardial infarction, stroke, unplanned revascularization and hospitalized unstable angina. RESULTS Significantly, HDL-C levels were negatively associated with coronary severity (p < 0.001). During an average of 27.32-month follow-up, 341 (8.12%) MACEs occurred. There was no significant difference of HDL-C levels between events group and non-events group. Furthermore, both Kaplan-Meier and Cox regression analyses found no relationship between HDL-C and cardiovascular outcomes (p > 0.05). CONCLUSIONS Plasma HDL-C levels appeared to be a predicator for coronary severity, but it is not associated with clinical outcomes in new-onset, Chinese patients with stable CAD.
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Affiliation(s)
- Hui-Hui Liu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Na-Qiong Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Ying Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Ping Qing
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Sha Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Xi Zhao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Yan Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Di Sun
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Geng Liu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China.
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30
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Garg A, Sharma A, Krishnamoorthy P, Garg J, Virmani D, Sharma T, Stefanini G, Kostis JB, Mukherjee D, Sikorskaya E. Role of Niacin in Current Clinical Practice: A Systematic Review. Am J Med 2017; 130:173-187. [PMID: 27793642 DOI: 10.1016/j.amjmed.2016.07.038] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/01/2016] [Accepted: 07/06/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Niacin, a potent high-density lipoprotein cholesterol-raising drug, seems an attractive approach to reduce cardiac events in patients with or at risk of atherosclerotic cardiovascular disease. However, previous evidence for niacin has been challenged recently by negative outcomes in 2 large, randomized, controlled trials comparing niacin to placebo with background statin therapy. We studied the currently available evidence for the role of niacin treatment for reducing the risk of cardiovascular events in current practice. METHODS A systematic review of randomized controlled trials in the MEDLINE, EMBASE, CINAHL, and Cochrane databases comparing niacin alone or combined with statin therapy was performed. We extracted trial level data, including basic characteristics and number of patients enrolled, duration of follow up, occurrence of adverse events, and cardiovascular-related outcomes. Random effects meta-analysis was conducted to estimate the risk ratio (RR) for individual trial endpoints. RESULTS Thirteen trials (N = 35,206) were selected for final analysis. The mean follow-up duration was 32.8 months. Overall, niacin led to significant increases in serum high-density lipoprotein cholesterol levels from baseline trial enrolment by 21.4%, 9.31 (95% confidence interval [CI] 5.11-13.51) mg/dL. However, we did not observe any differences in all-cause mortality rates (RR 0.99; 95% CI 0.88-1.12) between niacin and control arms. Further, niacin treatment was associated with a trend toward lower risk of cardiovascular mortality (RR 0.91; 95% CI 0.81-1.02), coronary death (RR 0.93; 95% CI 0.78-1.10), nonfatal myocardial infarction (RR 0.85; 95% CI 0.73-1.0), revascularization (coronary and noncoronary) (RR 0.83; 95% CI 0.65-1.06), and stroke (RR 0.89; 95% CI 0.72-1.10), compared with control. CONCLUSION Niacin therapy does not lead to significant reductions in total or cause-specific mortality or recurrent cardiovascular events among persons with or at risk of atherosclerotic cardiovascular disease.
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Affiliation(s)
- Aakash Garg
- Department of Medicine, St. Peter's University Hospital, Rutgers/Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Abhishek Sharma
- Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, Brooklyn, NY.
| | | | - Jalaj Garg
- Department of Cardiology, Lehigh Valley Health Network, Allentown, Penn
| | - Deepti Virmani
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Toishi Sharma
- Department of Medicine, Cleveland Clinic, Weston, Fla
| | - Giulio Stefanini
- Division of Cardiology, Humanitas Research Hospital, Rozzano, Italy
| | - John B Kostis
- Division of Cardiology, Cardiovascular Institute, Rutgers/Robert Wood Johnson Medical School, New Brunswick, NJ
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31
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Janghorbani M, Amini M, Aminorroaya A. Low Levels of High-Density Lipoprotein Cholesterol Do Not Predict the Incidence of Type 2 Diabetes in an Iranian High-Risk Population: The Isfahan Diabetes Prevention Study. Rev Diabet Stud 2016; 13:187-196. [PMID: 28012282 DOI: 10.1900/rds.2016.13.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To evaluate the ability of low-level fasting high-density lipoprotein cholesterol (HDLC) to predict the incidence of type 2 diabetes (T2D) in an Iranian high-risk population. METHODS Seven-year follow-up data (n = 1,775) in non-diabetic first-degree relatives (FDR) of consecutive patients with T2D aged 30-70 years were analyzed. The primary outcome was the diagnosis of T2D based on repeated oral glucose tolerance test (OGTT). We used Cox proportional hazard models to estimate the hazard ratio (HR) for the incidence of T2D across quartiles of HDLC, and plotted a receiver operating characteristic (ROC) curve to assess discrimination. RESULTS The highest quartile compared with the lowest quartile of HDLC was associated with T2D in age- and gender-adjusted models (HR: 0.83, 95% CI: 0.73-0.95). Further adjustment for fasting plasma glucose and cholesterol attenuated the association for T2D incidence (HR: 0.93, 95% CI: 0.80-1.08). The area under the ROC curve for HDLC was 54.1% (95% CI: 50.2-58.0). CONCLUSIONS HDLC level was a weak predictor of T2D in an Iranian high-risk population, independent of age and gender.
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Affiliation(s)
- Mohsen Janghorbani
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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32
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Hasvold P, Thuresson M, Sundström J, Hammar N, Kjeldsen SE, Johansson G, Holme I, Bodegård J. Association Between Paradoxical HDL Cholesterol Decrease and Risk of Major Adverse Cardiovascular Events in Patients Initiated on Statin Treatment in a Primary Care Setting. Clin Drug Investig 2016; 36:225-33. [PMID: 26718960 PMCID: PMC4761013 DOI: 10.1007/s40261-015-0372-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND OBJECTIVES Statin-induced changes in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) are unrelated. Many patients initiated on statins experience a paradoxical decrease in HDL-C. The aim of this study was to evaluate the association between a decrease in HDL-C and risk of major adverse cardiovascular events (MACE). METHODS Data from 15,357 primary care patients initiated on statins during 2004-2009 were linked with data from mandatory national hospital, drug-dispensing, and cause-of-death registers, and were grouped according to HDL-C change: decreased ≥0.1 mmol/L, unchanged ±0.1 or ≥0.1 mmol/L increased. To evaluate the association between decrease in HDL-C and risk of MACE, a sample of propensity score-matched patients from the decreased and unchanged groups was created, using the latter group as reference. MACE was defined as myocardial infarction, unstable angina pectoris, ischaemic stroke, or cardiovascular mortality. Cox proportional hazards models were used to estimate relative risks. RESULTS HDL-C decreased in 20%, was unchanged in 58%, and increased in 22% of patients initiated on statin treatment (96% treated with simvastatin). The propensity score-matched sample comprised 5950 patients with mean baseline HDL-C and LDL-C of 1.69 and 4.53 mmol/L, respectively. HDL-C decrease was associated with 56% higher MACE risk (hazard ratio 1.56; 95% confidence interval 1.12-2.16; p < 0.01) compared with the unchanged HDL-C group. CONCLUSIONS Paradoxical statin-induced reduction in HDL-C was relatively common and was associated with increased risk of MACE.
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Affiliation(s)
- Pål Hasvold
- AstraZeneca, 151 85, Södertälje, Sweden. .,Medical Faculty, University of Oslo, 0424, Oslo, Norway.
| | | | - Johan Sundström
- Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, 751 05, Uppsala, Sweden
| | - Niklas Hammar
- Institute of Environmental Medicine, Karolinska Institute, 171 77, Stockholm, Sweden.,Medical Evidence and Observational Research, AZ R&D, Mölndal, Sweden
| | - Sverre E Kjeldsen
- Medical Faculty, University of Oslo, 0424, Oslo, Norway.,Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Gunnar Johansson
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, 751 05, Uppsala, Sweden
| | - Ingar Holme
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ulleval Stadion, 0806, Oslo, Norway
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33
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Distelmaier K, Schrutka L, Wurm R, Seidl V, Arfsten H, Cho A, Manjunatha S, Perkmann T, Strunk G, Lang IM, Adlbrecht C. Gender-related impact on outcomes of high density lipoprotein in acute ST-elevation myocardial infarction. Atherosclerosis 2016; 251:460-466. [PMID: 27381657 DOI: 10.1016/j.atherosclerosis.2016.06.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 06/08/2016] [Accepted: 06/22/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS There is rising evidence that cardioprotective functions of high-density lipoprotein (HDL) have significant impact on clinical outcomes. ST-elevation myocardial infarction (STEMI) represents a high-risk vascular condition. Whether higher HDL-cholesterol concentrations in women correspond to protective anti-oxidant properties in the setting of STEMI is unknown. METHODS We prospectively assessed gender related differences in the anti-oxidant function of HDL, and the impact of HDL properties on mortality in 242 women and men with STEMI. Blood samples to determine HDL function and sex hormone levels were collected during primary percutaneous coronary intervention. RESULTS Patients were stratified according to preserved anti-oxidant HDL function (HDL oxidant index (HOI) < 1) and pro-oxidant HDL (HOI≥1). Despite higher serum levels of HDL-cholesterol in postmenopausal women (48 mg/dl, IQR 42-54, versus 39 mg/dl, IQR33-47, p < 0.001 in men), the proportion of patients with pro-oxidant HDL was not different between women (35%) and men (46%, p = 0.132). Kaplan-Meier analysis revealed higher cardiovascular mortality in both women (p = 0.021) and men (p = 0.045) with pro-oxidant HDL. We identified pro-oxidant HDL as strong and independent predictor of cardiovascular mortality with an adjusted HR of 8.33 (95% CI, 1.55-44.63; p = 0.013) in women and with an adjusted HR of 5.14 (95% CI, 1.61-16.42; p = 0.006) in men. Higher levels of free sex hormones (estradiol and testosterone) were associated with pro-oxidant HDL. HDL-cholesterol levels showed no association with mortality (HR in women 1.03, 95% CI 0.96-1.11, p = 0.45 and HR in men 0.99, 95% CI 0.94-1.05, p = 0.72). CONCLUSIONS Total HDL-cholesterol serum levels were not associated with mortality in STEMI patients. Pro-oxidant HDL was a strong and independent predictor of mortality in women and men with STEMI. The present study provides a link between sex hormones, HDL function and clinical events in STEMI patients. In clinical practice and future clinical trials, anti-oxidant properties of HDL rather than total HDL serum levels should be used for risk stratification.
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Affiliation(s)
- K Distelmaier
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - L Schrutka
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - R Wurm
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - V Seidl
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - H Arfsten
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - A Cho
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - S Manjunatha
- Division of Endocrinology and Metabolism, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - T Perkmann
- Department of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | - G Strunk
- Complexity-Research, Research Institute for Complex Systems, Vienna, Austria
| | - I M Lang
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria.
| | - C Adlbrecht
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria; 4th Medical Department, Hietzing Hospital, Vienna, Austria
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Hagström E, Roe MT, Hafley G, Neely ML, Sidhu MS, Winters KJ, Prabhakaran D, White HD, Armstrong PW, Fox KAA, Ohman EM, Boden WE. Association Between Very Low Levels of High-Density Lipoprotein Cholesterol and Long-term Outcomes of Patients With Acute Coronary Syndrome Treated Without Revascularization: Insights From the TRILOGY ACS Trial. Clin Cardiol 2016; 39:329-37. [PMID: 27177240 DOI: 10.1002/clc.22533] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 02/04/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Low levels of high-density lipoprotein cholesterol (HDL-C; <40 mg/dL) are associated with increased risk of cardiovascular events, but it is unclear whether lower thresholds (<30 mg/dL) are associated with increased hazard. HYPOTHESIS Very low levels of HDL-C may provide prognostic information in acute coronary syndrome (ACS) patients treated medically without revascularization. METHODS We examined data from 9064/9326 ACS patients enrolled in the TRILOGY ACS trial. Participants were randomized to clopidogrel or prasugrel plus aspirin. Study treatments continued for 6 to 30 months. Relationships between baseline HDL-C and the composite of cardiovascular death, myocardial infarction (MI), or stroke, and individual endpoints of death (cardiovascular and all-cause), MI, and stroke, adjusted for baseline characteristics through 30 months, were analyzed. The HDL-C was evaluated as a dichotomous variable-very low (<30 mg/dL) vs higher (≥30 mg/dL)-and continuously. RESULTS Median baseline HDL-C was 42 mg/dL (interquartile range, 34-49 mg/dL) with little variation over time. Frequency of the composite endpoint was similar for very low vs higher baseline HDL-C, with no risk difference between groups (hazard ratio [HR]: 1.13, 95% confidence interval [CI]: 0.95-1.34). Similar findings were seen for MI and stroke. However, risks for cardiovascular (HR: 1.42, 95% CI: 1.13-1.78) and all-cause death (HR: 1.36, 95% CI: 1.11-1.67) were higher in patients with very low baseline HDL-C. CONCLUSIONS Medically managed ACS patients with very low baseline HDL-C levels have higher risk of long-term cardiovascular and all-cause death but similar risks for nonfatal ischemic outcomes vs patients with higher baseline HDL-C.
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Affiliation(s)
- Emil Hagström
- Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Matthew T Roe
- Division of Cardiovascular Medicine, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Gail Hafley
- Department of Statistics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Megan L Neely
- Department of Statistics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Mandeep S Sidhu
- Department of Medicine, Albany Stratton VA Medical Center and Albany Medical Center, Albany Medical College, Albany, New York
| | | | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control and Public Health Foundation of India, New Delhi, India
| | - Harvey D White
- Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
| | - Paul W Armstrong
- Division of Cardiology, Department of Medicine/Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Keith A A Fox
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - E Magnus Ohman
- Division of Cardiovascular Medicine, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - William E Boden
- Department of Medicine, Albany Stratton VA Medical Center and Albany Medical Center, Albany Medical College, Albany, New York
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35
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Lee CH, Woo JS, Park CB, Cho JM, Ahn YK, Kim CJ, Jeong MH, Kim W. Roles of High-Density Lipoprotein Cholesterol in Patients With Acute Myocardial Infarction. Medicine (Baltimore) 2016; 95:e3319. [PMID: 27149442 PMCID: PMC4863759 DOI: 10.1097/md.0000000000003319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 11/12/2022] Open
Abstract
Many observational studies showed hogh-density lipoprotein cholesterol (HDL-C) is a strong inverse predictor of cardiovascular (CV) outcome. However, recent large clinical trials evaluating therapies to raise HDL-C level in those already on statin therapy have been discouraging. This complexity is not well-known.A total of 28,357 acute myocardial infarction (AMI) patients were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR), which was a prospective, multicenter, nationwide, web-based database of AMI in Korea. From this registry, we evaluated 3574 patients with AMI who have follow-up HDL-C level to investigate its association with clinical outcomes. The primary endpoint was the relationship between follow-up change in HDL-C and a 12-month composite of major adverse cardiac events (MACEs).Patients with initial HDL-C ≥ 40 mg/dL showed significantly lower rates of 12-month MACEs, especially cardiac and all-cause mortalities (P < 0.001). When patients were stratified into 4 groups according to the change of HDL-C, patients with decreasing HDL-C showed significantly higher rates of 12-month MACEs as comparable with patients with increasing HLD-C. A multivariate analysis indicated that HDL-C level was a significant predictor of CV events (hazard ratio, 1.38; 95% confidence interval, 1.12-1.71) after correcting for confounding variables.The follow-up change in HDL-C level was significantly related with CV outcomes in patients with AMI.
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Affiliation(s)
- Cheol Hyun Lee
- From the Department of Internal Medicine, Division of Cardiology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul (CHL, JSW, CBP, JMC, JK, WK); Department of Medicine, Division of Cardiology, Chonnam National University Hospital, Gwangju, Korea (YKA, MHJ)
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36
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van Herpt TTW, Dehghan A, van Hoek M, Ikram MA, Hofman A, Sijbrands EJG, Franco OH. The clinical value of metabolic syndrome and risks of cardiometabolic events and mortality in the elderly: the Rotterdam study. Cardiovasc Diabetol 2016; 15:69. [PMID: 27117940 PMCID: PMC4847340 DOI: 10.1186/s12933-016-0387-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 04/13/2016] [Indexed: 02/06/2023] Open
Abstract
Background To evaluate the clinical value of metabolic syndrome based on different definitions [American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), International Diabetes Federation (IDF) and European Group for the Study of Insulin Resistance (EGIR)] in middle-aged and elderly populations. Methods We studied 8643 participants from the Rotterdam study (1990–2012; mean age 62.7; 57.6 % female), a large prospective population-based study with predominantly elderly participants. We performed cox-proportional hazards models for different definitions, triads within definitions and each separate component for the risk of incident type 2 diabetes mellitus, coronary heart disease, stroke, cardiovascular- and all-cause mortality. Results In our population of 8643 subjects, metabolic syndrome was highly prevalent (prevalence between 19.4 and 42.4 %). Metabolic syndrome in general was associated with incident type 2 diabetes mellitus (median follow-up of 6.8 years, hazard ratios 3.13–3.78). The associations with coronary heart disease (median follow-up of 7.2 years, hazard ratios 1.08–1.32), stroke (median follow-up of 7.7 years, hazard ratios 0.98–1.32), cardiovascular mortality (median follow-up of 8.2 years, ratios 0.95–1.29) and all-cause mortality (median follow-up of 8.7 years, hazard ratios 1.05–1.10) were weaker. AHA/NHLBI- and IDF-definitions showed similar associations with clinical endpoints compared to the EGIR, which was only significantly associated with incident type 2 diabetes mellitus. All significant associations disappeared after correcting metabolic syndrome for its individual components. Conclusions Large variability exists between and within definitions of the metabolic syndrome with respect to risk of clinical events and mortality. In a relatively old population the metabolic syndrome did not show an additional predictive value on top of its individual components. So, besides as a manner of easy identification of high risk patients, the metabolic syndrome does not seem to add any predictive value for clinical practice. Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0387-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thijs T W van Herpt
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Mandy van Hoek
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Eric J G Sijbrands
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Impact of red blood cells count on the relationship between high density lipoproteins and the prevalence and extent of coronary artery disease: a single centre study [corrected]. J Thromb Thrombolysis 2016; 40:61-8. [PMID: 25680891 DOI: 10.1007/s11239-015-1174-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We have hypothesized that high red blood cells (RBC) count can potentially play an atheroprotective role in patients with coronary atherosclerosis. We, therefore, have investigated the relationship between high density lipoproteins cholesterol (HDL-C) and RBC levels in patients undergoing coronary angiography. Coronary artery disease (CAD) is a major cause of mortality. Impaired lipid profile represents a major risk factor for atherosclerosis. High density lipoprotein (HDL) is a key factor in atherosclerosis disease development. RBC can mimic HDL's reverse cholesterol transportation with a potential atheroprotective role. Coronary angiography has been evaluated in 3,534 patients. Fasting samples were collected for haematology and lipids levels assessment. Coronary disease was defined for at least 1 vessel stenosis >50 %. Patients were divided according to HDL-C and RBC tertiles. Lower HDL-C was significantly associated to the prevalence of CAD (84.8 vs 78.5 vs 67.3 %, p ≤ 0.001; adjusted OR [95 % CI] = 1.55 [1.3-1.8], p < 0.001) and severe CAD (30 % vs 30 % vs 24.4 %, p = 0.002; adjusted OR [95 % CI] = 1.08 [1.01-1.16], p = 0.02), this relationship was maintained even dividing our population according to RBC tertiles (p < 0.001).In conclusion, HDL-C levels are directly related to RBC count and inversely to the prevalence and extent of coronary disease. Higher RBC levels can reduce the risk of CAD in patients with lower HDL-C levels, suggesting an important atheroprotective role.
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Papageorgiou N, Zacharia E, Androulakis E, Briasoulis A, Charakida M, Tousoulis D. HDL as a prognostic biomarker for coronary atherosclerosis: the role of inflammation. Expert Opin Ther Targets 2016; 20:907-21. [PMID: 26854521 DOI: 10.1517/14728222.2016.1152264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Emerging evidence suggests that the role of high density lipoprotein (HDL) in the atherosclerotic process is not as clear as previously thought, since atheroprotective HDL becomes atherogenic in states of increased inflammatory processes. AREAS COVERED In this review we aim to elucidate the role of HDL as a prognostic biomarker and we discuss therapeutic approaches that aim to increase HDL and their possible clinical benefit. EXPERT OPINION Given the structural variability and biological complexity of the HDL particle, its role in the atherosclerotic process is far from clear. According to current evidence, the atheroprotective role of HDL turns atherogenic in states of increased inflammatory processes, while even minor alterations in systemic inflammation are likely to hinder the endothelial protective effects of HDL. In accordance, significant data have revealed that HDL-related drugs may be effective in reducing cardiovascular mortality; however they are not as encouraging or unanimous as expected. Possible future goals could be to quantify either HDL subclasses or functions in an attempt to reach safer conclusions as to the prognostic importance of HDL in coronary atherosclerosis. Having achieved that, a more targeted therapy that would aim to raise either HDL functionality or to remodel HDL structure would be more easily designed.
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Affiliation(s)
| | - Effimia Zacharia
- b 1st Department of Cardiology , Hippokration Hospital, University of Athens , Athens , Greece
| | | | - Alexandros Briasoulis
- d Division of Cardiology , Wayne State University/Detroit Medical Center , Detroit , MI , USA
| | - Marietta Charakida
- e Vascular Physiology Unit, Institute of Cardiovascular Science , University College London , London , UK
| | - Dimitris Tousoulis
- b 1st Department of Cardiology , Hippokration Hospital, University of Athens , Athens , Greece
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Xu RX, Zhang Y, Ye P, Chen H, Li YF, Hua Q, Guo YL, Li XL, Li S, Dong Q, Liu G, Li JJ. Analysis of Lipoprotein Subfractions in Chinese Han Patients with Stable Coronary Artery Disease. Heart Lung Circ 2015; 24:1203-10. [PMID: 26105990 DOI: 10.1016/j.hlc.2015.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 04/08/2015] [Accepted: 05/02/2015] [Indexed: 12/22/2022]
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Serban MC, Banach M, Mikhailidis DP. Clinical implications of the IMPROVE-IT trial in the light of current and future lipid-lowering treatment options. Expert Opin Pharmacother 2015; 17:369-80. [PMID: 26559810 DOI: 10.1517/14656566.2016.1118055] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION A residual risk of morbidity and mortality from cardiovascular (CV) disease remains despite statin therapy. This situation has generated an interest in finding novel approaches of combining statins with other lipid-lowering agents, or finding new lipid and non-lipid targets, such as triglycerides, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, proprotein convertase subtilisin/kexin type 9 (PCSK9) gene, cholesterol ester transfer protein (CETP), lipoprotein (a), fibrinogen or C-reactive protein. AREAS COVERED The recent results from the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) demonstrated an incremental clinical benefit when ezetimibe, a non-statin agent, was added to simvastatin therapy. EXPERT OPINION The results from IMPROVE-IT revalidated the concept that low-density lipoprotein cholesterol (LDL-C) levels are a clinically relevant treatment goal. This trial also suggested that further decrease of LDL-C levels (53 vs. 70 mg/dl; 1.4 vs. 1.8 mmol/l) was more beneficial in lowering CV events. This "even lower is even better" evidence for LDL-C levels may influence future guidelines and the use of new drugs. Furthermore, these findings make ezetimibe a more realistic option to treat patients with statin intolerance or those who cannot achieve LDL-C targets with statin monotherapy.
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Affiliation(s)
- Maria-Corina Serban
- a Department of Epidemiology , University of Alabama at Birmingham , Birmingham , USA.,b Department of Functional Sciences, Discipline of Pathophysiology , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
| | - Maciej Banach
- c Department of Hypertension, Chair of Nephrology and Hypertension , Medical University of Lodz , Lodz , Poland
| | - Dimitri P Mikhailidis
- d Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School , University College London (UCL) , London , UK
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Sprandel MCO, Hueb WA, Segre A, Ramires JAF, Kalil-Filho R, Maranhão RC. Alterations in lipid transfers to HDL associated with the presence of coronary artery disease in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2015; 14:107. [PMID: 26268997 PMCID: PMC4535391 DOI: 10.1186/s12933-015-0270-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/01/2015] [Indexed: 12/02/2022] Open
Abstract
Background We previously showed that unesterified-cholesterol transfer to high-density lipoprotein (HDL), a crucial step in cholesterol esterification and role in reverse cholesterol transport, was diminished in non-diabetic patients with coronary artery disease (CAD). The aim was to investigate whether, in patients with type 2 diabetes mellitus (T2DM), the occurrence of CAD was also associated with alterations in lipid transfers and other parameters of plasma lipid metabolism. Methods Seventy-nine T2DM with CAD and 76 T2DM without CAD, confirmed by cineangiography, paired for sex, age (40–80 years), BMI and without statin use, were studied. In vitro transfer of four lipids to HDL was performed by incubating plasma of each patient with a donor emulsion containing radioactive lipids during 1 h at 37 °C. Lipids transferred to HDL were measured after chemical precipitation of non-HDL fractions and the emulsion. Results are expressed as % of total radioactivity of each lipid in HDL. Results In T2DM + CAD, LDL-cholesterol and apo B were higher than in T2DM. T2DM + CAD also showed diminished transfer to HDL of unesterified cholesterol (T2DM + CAD = 7.6 ± 1.2; T2DM = 8.2 ± 1.5 %, p < 0.01) and of cholesteryl-esters (4.0 ± 0.6 vs 4.3 ± 0.7, p < 0.01). Unesterified cholesterol in the non-HDL serum fraction was higher in T2DM + CAD (0.93 ± 0.20 vs 0.85 ± 0.15, p = 0.02) and CETP concentration was diminished (2.1 ± 1.0 vs 2.5 ± 1.1, p = 0.02). Lecithin-cholesterol acyltransferase activity, HDL size and lipid composition were equal. Conclusion Reduction in T2DM + CAD of cholesterol transfer to HDL may impair cholesterol esterification and reverse cholesterol transport and altogether with simultaneous increased plasma unesterified cholesterol may facilitate CAD development in T2DM.
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Affiliation(s)
- Marilia C O Sprandel
- Lipid Metabolism Laboratory, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil.
| | - Whady A Hueb
- Clinical Cardiology Division, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil.
| | - Alexandre Segre
- Clinical Cardiology Division, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil.
| | - José A F Ramires
- Clinical Cardiology Division, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil.
| | - Roberto Kalil-Filho
- Clinical Cardiology Division, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil.
| | - Raul C Maranhão
- Lipid Metabolism Laboratory, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil. .,Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.
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Ladeiras-Lopes R, Agewall S, Tawakol A, Staels B, Stein E, Mentz RJ, Leite-Moreira A, Zannad F, Koenig W. Atherosclerosis: Recent trials, new targets and future directions. Int J Cardiol 2015; 192:72-81. [DOI: 10.1016/j.ijcard.2015.05.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/09/2015] [Accepted: 05/06/2015] [Indexed: 12/14/2022]
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Effects of change in high-density lipoprotein cholesterol by statin switching on glucose metabolism and renal function in hypercholesterolemia. J Clin Lipidol 2015; 9:709-15. [PMID: 26350819 DOI: 10.1016/j.jacl.2015.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 07/10/2015] [Accepted: 07/18/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent reports have suggested that high-density lipoprotein (HDL) is metabolically related to glucose metabolism and renal function. Statin administration clinically increases HDL cholesterol (HDL-C). OBJECTIVE To confirm that change in HDL-C by statin switching is associated with glucose metabolism and renal function in hypercholesterolemic patients. METHODS In hypercholesterolemic outpatients (n = 129) who had taken either statin, as atorvastatin, pitavastatin, or rosuvastatin and switched to another statin, the relationship of change in HDL-C to glycated hemoglobin and estimated glomerular filtration rate (eGFR) was assessed. RESULTS Change in HDL-C did not significantly correlate with change in HbA1c, eGFR calculated from creatinine (eGFRcre), and eGFR calculated from cystatin C (eGFRcys). The subjects were then divided into 2 groups by change in HDL-C: no change or decrease in HDL-C (HD group) and increase in HDL-C (HI group). In the HI group, apolipoprotein A-1 (Apo A-1) and eGFRs were significantly increased by statin switching. There were significant differences in changes in HDL-C, Apo A-1, lipoprotein lipase, glycated hemoglobin, and eGFR calculated from creatinine between the groups. In the patients with impaired glucose tolerance or diabetes, change in HbA1c was also significant between the groups. CONCLUSIONS Our data suggest that an increase in HDL-C due to statin switching is associated with improvement in glucose metabolism and renal function.
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Ru D, Zhiqing H, Lin Z, Feng W, Feng Z, Jiayou Z, Yusheng R, Min F, Chun L, Zonggui W. Oxidized high-density lipoprotein accelerates atherosclerosis progression by inducing the imbalance between treg and teff in LDLR knockout mice. APMIS 2015; 123:410-21. [PMID: 25912129 DOI: 10.1111/apm.12362] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 12/01/2014] [Indexed: 01/21/2023]
Abstract
High density lipoprotein (HDL) dysfunction has been widely reported in clinic, and oxidation of HDL (ox-HDL) was shown to be one of the most common modifications in vivo and participate in the progression of atherosclerosis. But the behind mechanisms are still elusive. In this study, we firstly analyzed and found strong relationship between serum ox-HDL levels and risk factors of coronary artery diseases in clinic, then the effects of ox-HDL in initiation and progression of atherosclerosis in LDLR knockout mice were investigated by infusion of ox-HDL dissolved in chitosan hydrogel before the formation of lesions in vivo. Several new evidence were shown: (i) the serum levels of ox-HDL peaked early before the formation of lesions in LDLR mice fed with high fat diet similar to oxidative low density lipoprotein, (ii) the formation of atherosclerotic lesions could be accelerated by infusion of ox-HDL, (iii) the pro-atherosclerotic effects of ox-HDL were accompanied by imbalanced levels of effector and regulatory T cells and relative gene expressions, which implied that imbalance of teff and treg might contribute to the pro-atherosclerosis effects of ox-HDL.
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Affiliation(s)
- Ding Ru
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
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Kim DS, Burt AA, Ranchalis JE, Vuletic S, Vaisar T, Li WF, Rosenthal EA, Dong W, Eintracht JF, Motulsky AG, Brunzell JD, Albers JJ, Furlong CE, Jarvik GP. PLTP activity inversely correlates with CAAD: effects of PON1 enzyme activity and genetic variants on PLTP activity. J Lipid Res 2015; 56:1351-62. [PMID: 26009633 DOI: 10.1194/jlr.p058032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Indexed: 01/07/2023] Open
Abstract
Recent studies have failed to demonstrate a causal cardioprotective effect of HDL cholesterol levels, shifting focus to the functional aspects of HDL. Phospholipid transfer protein (PLTP) is an HDL-associated protein involved in reverse cholesterol transport. This study sought to determine the genetic and nongenetic predictors of plasma PLTP activity (PLTPa), and separately, to determine whether PLTPa predicted carotid artery disease (CAAD). PLTPa was measured in 1,115 European ancestry participants from a case-control study of CAAD. A multivariate logistic regression model was used to elucidate the relationship between PLTPa and CAAD. Separately, a stepwise linear regression determined the nongenetic clinical and laboratory characteristics that best predicted PLTPa. A final stepwise regression considering both nongenetic and genetic variables identified the combination of covariates that explained maximal PLTPa variance. PLTPa was significantly associated with CAAD (7.90 × 10(-9)), with a 9% decrease in odds of CAAD per 1 unit increase in PLTPa (odds ratio = 0.91). Triglyceride levels (P = 0.0042), diabetes (P = 7.28 × 10(-5)), paraoxonase 1 (PON1) activity (P = 0.019), statin use (P = 0.026), PLTP SNP rs4810479 (P = 6.38 × 10(-7)), and PCIF1 SNP rs181914932 (P = 0.041) were all significantly associated with PLTPa. PLTPa is significantly inversely correlated with CAAD. Furthermore, we report a novel association between PLTPa and PON1 activity, a known predictor of CAAD.
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Affiliation(s)
- Daniel Seung Kim
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA Department of Biostatistics, University of Washington School of Public Health, Seattle, WA
| | - Amber A Burt
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Jane E Ranchalis
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Simona Vuletic
- Northwest Lipid Metabolism and Diabetes Research Laboratories, Seattle, WA Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Tomas Vaisar
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Wan-Fen Li
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Elisabeth A Rosenthal
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Weijiang Dong
- Northwest Lipid Metabolism and Diabetes Research Laboratories, Seattle, WA Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Human Anatomy and Histology and Embryology, Xi'an Jiaotong University School of Medicine, Xi'an 710061, People's Republic of China
| | - Jason F Eintracht
- Department of General Medicine, Virginia Mason Medical Center, Seattle, WA
| | - Arno G Motulsky
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA
| | - John D Brunzell
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - John J Albers
- Northwest Lipid Metabolism and Diabetes Research Laboratories, Seattle, WA Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Clement E Furlong
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA
| | - Gail P Jarvik
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA
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Is HPS2-THRIVE the death knell for niacin? J Clin Lipidol 2015; 9:343-50. [DOI: 10.1016/j.jacl.2015.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 01/22/2015] [Accepted: 01/25/2015] [Indexed: 11/20/2022]
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Karabacak M, Kahraman F, Sert M, Celik E, Adali MK, Varol E. Increased plasma monocyte chemoattractant protein-1 levels in patients with isolated low high-density lipoprotein cholesterol. Scandinavian Journal of Clinical and Laboratory Investigation 2015; 75:327-32. [PMID: 25797068 DOI: 10.3109/00365513.2014.1003595] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND High-density lipoprotein cholesterol (HDL-C) inhibits inflammation associated with the development of atherosclerotic plaques. Monocyte chemoattractant protein-1 (MCP-1) contributes to the pathogenesis of atherosclerosis. The aim of this study was to evaluate the relationship between plasma MCP-1 levels and low HDL-C levels in patients without cardiovascular disease (CVD). METHODS This study included 55 patients with low HDL-C (≤ 35 mg/dL) and 33 age- and sex-matched control subjects with normal HDL-C (˃ 35 mg/dL). In addition to MCP-1 levels, laboratory parameters associated with inflammation such as neutrophil-lymphocyte ratio (NLR), uric acid and high sensitivity C-reactive protein (hs-CRP) were also evaluated. RESULTS HDL-C levels was significantly lower in study group compared to that of the control group (p < 0.001). MCP-1 were prominently higher in the low HDL-C group compared with those of the control group (p < 0.01). NLR, uric acid and hs-CRP levels were also higher in patients with low HDL-C than controls. CONCLUSION These findings suggest that elevated plasma MCP-1 levels and inflammation status might be associated with the increased cardiovascular risk in patients with low HDL-C.
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Sionis A, Ruiz-Nodar JM, Fernández-Ortiz A, Marín F, Abu-Assi E, Díaz-Castro O, Nuñez-Gil IJ, Lidón RM. Actualización en cardiopatía isquémica y cuidados críticos cardiológicos. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Puri R, Nissen SE, Shao M, Kataoka Y, Uno K, Kapadia SR, Tuzcu EM, Nicholls SJ. The beneficial effects of raising high-density lipoprotein cholesterol depends upon achieved levels of low-density lipoprotein cholesterol during statin therapy: Implications for coronary atheroma progression and cardiovascular events. Eur J Prev Cardiol 2015; 23:474-85. [DOI: 10.1177/2047487315572920] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/25/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Rishi Puri
- Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland, Ohio, USA
- Department of Cardiovascular Medicine, Cleveland Clinic, Ohio, USA
| | - Steven E Nissen
- Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland, Ohio, USA
- Department of Cardiovascular Medicine, Cleveland Clinic, Ohio, USA
| | - Mingyuan Shao
- Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland, Ohio, USA
| | - Yu Kataoka
- South Australian Health and Medical Research Institute, University of Adelaide, South Australia
| | - Kiyoko Uno
- Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland, Ohio, USA
| | - Samir R Kapadia
- Department of Cardiovascular Medicine, Cleveland Clinic, Ohio, USA
| | - E Murat Tuzcu
- Department of Cardiovascular Medicine, Cleveland Clinic, Ohio, USA
| | - Stephen J Nicholls
- South Australian Health and Medical Research Institute, University of Adelaide, South Australia
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Update on ischemic heart disease and intensive cardiac care. ACTA ACUST UNITED AC 2015; 68:234-41. [PMID: 25670216 DOI: 10.1016/j.rec.2014.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 11/12/2014] [Indexed: 01/11/2023]
Abstract
This article summarizes the main developments reported in 2014 on ischemic heart disease, together with the most important innovations in intensive cardiac care.
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